Intranasal steroid aerosol in perennial rhinitis: comparison with an antihistamine compound

Harding, S. M.; Heath, Sarah

doi:10.1111/j.1365-2222.1976.tb01918.x

Cited by 25 publications

(7 citation statements)

References 8 publications

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“…Evaluation of the data separately at each provocation step by Mests both with and without correction for baseline difl"erences gave similar results. Symptom score data were evaluated separately (Mests) at each provocation step: 10, 100, 1000, and 10000SQ-U/ml(runs7, 9,11,13) for the four score variables: itch, sneeze, secretion, and blockage ( Fig. 2).…”

Section: Resultsmentioning

confidence: 99%

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Effect of terfenadine and budesonide on nasal symptoms, olfaction, and nasal airway patency following allergen challenge

Hilberg

1995

Allergy

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The study investigated the effect of the oral H1-blocker terfenadine on allergen challenge in subjects with nasal allergy in comparison with the topical steroid, budesonide. A randomized, placebo-controlled, double-blind, crossover study with 3 experimental days was performed outside the pollen season. Seventeen nonsmokers with hay fever (symptoms, positive skin prick test, and RAST against timothy) were treated for 14 days before each experimental day, where the response to nasal challenge with four different concentrations of timothy was measured every 15 min for 6 h. The nasal cavity dimensions were measured by acoustic rhinometry and the olfactory function as the threshold for the sense of smell of butanol. Nasal symptoms were determined by questionnaires. Both terfenadine and budesonide dry powder had an effect on the hay fever symptoms during nasal pollen challenge. Terfenadine was more efficient than budesonide against histamine-mediated symptoms such as sneezing and itching. Budesonide increased nasal airway dimensions better than terfenadine (P < 0.01). A marked effect of budesonide was seen 1-2 h after challenge, suggesting an effect on "early late phase" reaction in the nose. In 7/17 subjects, a significant (P < 0.05) improvement of olfactory function after budesonide treatment was seen. In conclusion, topical steroid (budesonide) is superior to antihistamine (terfenadine) in treatment of nasal congestion in hay fever, especially for the postchallenge reaction, and may, in some cases, relieve the decreased sense of smell during pollen challenge.

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Section: Resultsmentioning

confidence: 99%

“…Only a few comparisons have been made between steroids and the new nonsedating antihistamines on blockage in hay fever (8,9,21), and although steroids are advocated in case of blockage instead of antihistamines (12,16), we find that further study by acoustic rhinometry, a more recent objective method for evaluation of nasal patency, is justified.…”

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confidence: 92%

Effect of terfenadine and budesonide on nasal symptoms, olfaction, and nasal airway patency following allergen challenge

Hilberg

1995

Allergy

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“…Reasons for exclusion were use of: non-random allocation, 28 29 a single blind protocol, 30 31 combined intranasal corticosteroid and oral antihistamines in the comparison arm, 32 33 topical antihistamines in the comparison arm, 34 35 decongestant in the comparison arm,36 – 38 non-clinical challenge or outcome, 39 40 and the publication of an abstract only without reporting detailed results 41 – 43…”

Section: Methodsmentioning

confidence: 99%

Intranasal corticosteroids versus oral H1 receptor antagonists in allergic rhinitis: systematic review of randomised controlled trials

Weiner

Abramson

Puy

1998

BMJ

488

274

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Objective To determine whether intranasal corticosteroids are superior to oral H 1 receptor antagonists (antihistamines) in the treatment of allergic rhinitis. Design Meta-analysis of randomised controlled trials comparing intranasal corticosteroids with oral antihistamines. Setting Randomised controlled trials conducted worldwide and published between 1966 and 1997. Subjects 2267 subjects with allergic rhinitis in 16 randomised controlled trials. Main outcome measures Nasal blockage, nasal discharge, sneezing, nasal itch, postnasal drip, nasal discomfort, total nasal symptoms, nasal resistance, and eye symptoms and global ratings. Outcomes measured on different scales were combined to determine pooled odds ratios (categorical outcomes) or standardised mean differences (continuous outcomes). Assessment of heterogeneity between studies, and subgroup analyses of eye symptoms, were undertaken. Results Intranasal corticosteroids produced significantly greater relief than oral antihistamines of nasal blockage (standardised mean difference − 0.63, 95% confidence interval − 0.73 to − 0.53), nasal discharge ( − 0.5, − 0.6 to − 0.4), sneezing ( − 0.49, − 0.59 to − 0.39), nasal itch ( − 0.38, − 0.49 to − 0.21), postnasal drip ( − 0.24, − 0.42 to − 0.06), and total nasal symptoms ( − 0.42, − 0.53 to − 0.32), and global ratings gave an odds ratio for deterioration of symptoms of 0.26 (0.08 to 0.8). There were no significant differences between treatments for nasal discomfort, nasal resistance, or eye symptoms. The effects on sneezing, total nasal symptoms, and eye symptoms were significantly heterogeneous between studies. Other combined outcomes were homogeneous between studies. Subgroup analysis of the outcome of eye symptoms suggested that the duration of assessment (averaged mean score over the study period versus mean score at end of study period) might have accounted for the heterogeneity. Conclusion The results of this systematic review, together with data on safety and cost effectiveness, support the use of intranasal corticosteroids over oral antihistamines as first line treatment for allergic rhinitis.

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“…In comparison with antihistamines, one study has shown equal efficacy on nasal symptoms (192), while seven double-blind studies have demonstrated the GCS spray to be more effective, especially for nasal blockage (17,25,57,65,78,104,150).…”

Section: Comparison With Other Treatmentsmentioning

confidence: 99%

Glucocorticosteroids and rhinitis

Mygind

1993

Allergy

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Intranasal steroid aerosol in perennial rhinitis: comparison with an antihistamine compound

Cited by 25 publications

References 8 publications

Effect of terfenadine and budesonide on nasal symptoms, olfaction, and nasal airway patency following allergen challenge

Effect of terfenadine and budesonide on nasal symptoms, olfaction, and nasal airway patency following allergen challenge

Intranasal corticosteroids versus oral H1 receptor antagonists in allergic rhinitis: systematic review of randomised controlled trials

Glucocorticosteroids and rhinitis

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